K-ras、Livin在不同胃黏膜病变中的表达及临床意义

Expression of K-ras,Livin in different gastric mucosa lesions and its clinical significance

目的探讨K-ras、Livin在不同胃黏膜组织中的表达,并分析其与胃癌发生发展及预后的关系。方法采用SP免疫组化方法检测胃癌90例及高级别上皮内瘤变、低级别上皮内瘤变、肠上皮化生、浅表性胃炎、正常胃黏膜各30例的6组不同胃黏膜组织K-ras、Livin表达,进行临床病理相关性分析。结果 1随着胃组织的病变发展,在浅表性胃炎、肠上皮化生、上皮内瘤变、胃癌中K-ras、Livin的阳性表达率均呈逐渐增加(0,23.3%,28.3%,68.9%,P<0.001;0,13.3%,23.3%,57.8%,P<0.001),但低级别上皮内瘤变组低于肠上皮化生组(13.3%vs 23.3%;10.0%vs 13.3%),而低级别上皮内瘤变、肠上皮化生、浅表性胃炎、正常胃黏膜四组之间差异不显著(13.3%,23.3%,0,6.7%,P>0.05;10.0%,13.3%,0,13.3%,P>0.05),高级别上皮内瘤变明显高于低级别上皮内瘤变(43.3%vs 13.3%,P<0.05;36.7%vs 10.0%,P<0.05)。2在90例胃癌中K-ras、Livin阳性表达率显著高于低级别上皮内瘤变、肠上皮化生、浅表性胃炎和正常胃黏膜(P<0.01),明显高于高级别上皮内瘤变(P<0.05);在胃癌中K-ras、Livin表达与年龄、分化程度、浸润深度和淋巴结转移密切相关(均P<0.05)。3240例不同胃黏膜病变中K-ras与Livin二者之间表达呈正相关(P<0.001),K-ras(+)Livin(+)者在胃癌浸润深度T3-T4和淋巴结转移的比率最高,且明显高于K-ras(-)Livin(-)者(P<0.05)。结论 K-ras、Livin表达均与胃癌的发生发展及预后有关,二者可作为较为理想的肿瘤标志物,用于胃癌早期诊断和转移的预警。

Objective To explore the expression of K-ras and Livin in different gastric mueosa lesions and evaluate its role in occurrence, development and prognosis of gastric cancer. Methods Expression of K-ras and Livin was detected in 90 cases of gastric cancer ,30 cases of high-grade intraepithelial neoplasia, 30 cases of low-grade intraepithelial neoplasia,30 cases of intestinal metaplasia, 30 cases of superficial gastritis,30 cases of normal gastric mucosa using SP method. The correlation between expression of K-ras and Livin and clinical pathological features was analyzed. Results ①The positive expression rate of K-ras and Livin increased in superficial gastritis, intestinal metaplasia, intraepithelial neoplasia and gastric cancer （0,23.3%, 28.3%, 68.9%, P 〈 0. 001 ; 0,13.3%, 23.3 %,57.8 %, P 〈 0.001 ）. The positive expression rates of K-ras and Livin were lower in low-grade intraepithelial neoplasia than in intestinal metaplasia（ 13.3% vs 23.3%;10.0% vs 13.3%）, but there was no significant difference among low-grade intraepithelial neoplasia, intestinal metaplasia, superficial gastritis and normal gastric mucosa（ 13.3%,23.3%,0,6.7%,P 〉 0.05 ; 10.0%, 13.3%,0, 13.3%,P 〉 0.05）, while the positive expression rates of K-ras and Livin high-grade intraepithelial neoplasia were significantly higher than low-grade intraepithelial neoplasia（43.3% vs 13.3%,P 〈 0.05 ;36.7% vs 10.0%,P 〈 0.05 ）. ②The expression rates of K-ras and Livin were both significantly higher in gastric cancer than in low-grade intraepithelial neoplasia, intestinal metaplasia, superficial gas- tritis and normal gastric mucosa（P 〈 0.01 ） and high-grade intraepithelial neoplasia （ P 〈 0.05 ）. The expression rate of K-ras and Livin was closely related with age, degree of differentiation, tumor invasion depth and lymph node metastasis（P 〈 0.05）. ③The expression of K-ras in 240 cases of different gastric mucosa lesions was positively correlated with Livin（P 〈 0. 001 ）. The incidences of stage T3 - T4 of tumor invasion depth and lymph node metastasis were the highest in cases of K-ras（＋） and Livin（＋） and significantly higher than that in cases of K-ras （-） and Livin（-） （P 〈 0.05）. Conclusion The expression of Livin and K-ras is related to the development and prognosis of gastric cancer,both can be used as ideal tumor markers for early diagnosing gastric cancer and warning metastasis.